Christina Spicer  |  November 23, 2020

Category: Legal News

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X-rays of artificial hipsSigns and symptoms of metallosis caused by a metal-on-metal hip implant may include joint pain, cardiomyopathy, nerve problems, thyroid complications, and more.

What is Metallosis?

Metallosis, is a medical condition involving the build of metallic debris in the body, usually the soft tissues. When metal debris are released into the body, it is thought that the immune system attacks these particles which can lead to inflammation. However, this theory has not been proven.

What Causes Metallosis?

Metallosis is most commonly seen in patients with metal-on-metal implants, most commonly hip replacements. These implants use metal for all of the articulating surfaces, which is thought to generate metal debris as the implant components wear on each other.

Most metal on metal implants utilize chromium or cobalt metals in their components, but others may use nickel, titanium, and molybdenum as well. Surfaces containing these metals may rub together in metal on metal hip implants, leading to the release of metal debris which causes metallosis.

The U.S. Food and Drug Administration (FDA) recognizes the metal-on-metal hip replacements have “unique risks” including the “release of metal particles.”

“Over time, the metal particles around some implants can cause damage to bone and/or tissue surrounding the implant and joint,” the FDA says. “Soft tissue damage may lead to pain, implant loosening, device failure, and the need for revision surgery. […] Patients with a progressing [adverse local tissue reaction] may be considered for earlier revision to prevent extensive damage to bone, muscle and nerves.”

Although metallosis is most commonly seen with metal on metal hip replacements (occurring in about 5% of patients), the condition can also happen in patients with other implants.

A 2014 case study published in the European Journal of Radiology Open detailed the case of a 55-year-old man who was diagnosed with metallosis despite not having a metal on metal hip replacement. The man reportedly had a ceramic-ceramic hip replacement in his right hip and a metal-plastic hip replacement in his left hip.

According to the case study, the man came to the emergency department due to pain, fever, and “red urine.” Puncturing of a mass in the right hip reportedly resulting in the draining of a black liquid – “indicating metallosis diagnosis.” The black color of the drained liquid usually isn’t necessary to diagnose the condition but indicates metallic debris.

“Metallosis occurs not only in metal-on-metal prostheses but also in non-metallic prostheses, and it has a very wide and nonspecific clinical presentation,” the researchers concluded.

Metallosis Effects on Neurology

What are the signs and symptoms of metallosis?According to a study published in BMC Psychiatry in 2017, researchers found neuropsychiatric complications among patients who suffered from metallosis after metal-on-metal hip implant failure.

The study was conducted by Ben Green and Solomon Almond, both of The Institute of Medicine, University of Chester and University Centre Shrewsbury and Emily Griffiths of Public Health England.

Researchers evaluated ten cases; all patients were of the mean age of 60 years old who had received ASR total hip replacements between 2005 and 2009.

Prior to revision surgery, nine of the patients’ blood tests indicated toxic levels of chromium and cobalt. All of the patients were suffering from depression, and three of those were being treated for depression.

Seven of the nine patients tested at a mean Mini Mental State Examination (MMSE) score of 24.2. Researchers said the normal population mean MMSE score for that age group would be expected to be a 28. Anything under 25 is indicative of possible dementia.

Other potential neurological problems include changes in vision due to interferences with visual neurological pathways.

“We found neurocognitive and depressive deficits after cobalt and chromium metallosis following MoM (metal-on-metal) implant failure,” said researchers, who recommended that larger studies of neurocognitive effects should be completed. They cited the potential public health implications for care needed to assist the potential thousands of patients who may experience progressive cognitive decline and dementia because of metal poisoning.

Other complications can occur from metallosis as well. Even though chromium is an essential trace nutrient, too much of it may cause skin and respiratory tract inflammation, gastrointestinal problems, cardiovascular events, and an increased risk of cancer.

What Are the Signs and Symptoms of Metallosis?

Signs and symptoms of metallosis may vary, but can reportedly include:

  • Pain
  • Tissue death
  • Cardiomyopathy
  • Mental problems (depression, anxiety, etc.)
  • Visual impairment potentially leading to blindness
  • Nervous system problems
  • Thyroid problems
  • Auditory issues potentially leading to deafness
  • Skin rashes
  • Infection
  • Implant loosening
  • Pseudotumor formation

Symptoms may vary based on a person’s reaction to elevated cobalt levels in the body and the level of metals found in the blood. Doctors can test the level of metal in the blood with a simple blood draw. Higher levels of metal in the blood are associated with more severe symptoms while lower levels may only result in pain.

Treating metallosis generally requires revision surgery to remove the problematic implant and replace it. Unfortunately, hip revision surgery brings with it its own risks, and the success rate of hip revision surgery is lower than that of the initial implantation.

Moreover, hip revision surgery may not be able to fix all of the problems caused by a problematic hip implant. One woman who had a metal-on-metal hip implant says she suffered from a variety of symptoms, like her hair falling out, nails tearing, and a general feeling of unwellness.

Her doctors initially thought she had pneumonia, she said, until blood tests confirmed metal poisoning, with levels of chromium and cobalt nearly a hundred times the standard range. She also began suffering from major heart issues. While she was able to have her hip implant removed, those heart issues—including congestive heart failure—cannot be fixed by hip implant removal surgery.

Can I File a Metallosis Hip Implant Lawsuit?

So far, thousands of patients have filed lawsuits over metal hip implant complications, including metallosis. Lawsuits allege that the manufacturers of these devices failed to adequately warn both patients and the medical community about the risks associated with their metal-on-metal hip implants, such as metallosis and the need for hip revision surgery.

If you or someone you love has suffered from complications caused by metal-on-metal hip implants or hip revision surgery, you may be able to file a lawsuit and pursue compensation. Of course, filing a lawsuit cannot take away the pain and suffering caused by complications from a surgery, but it can at least help to alleviate the burden incurred by medical expenses, lost wages, and more.

Filing a lawsuit can be a daunting prospect, especially while also dealing with health complications, so Top Class Actions has laid the groundwork for you by connecting you with an experienced attorney. Consulting an attorney can help you determine if you have a claim, navigate the complexities of litigation, and maximize your potential compensation.

Metal Hip Implant Lawsuits and Settlements

Plaintiffs who allege they suffered the signs and symptoms of metallosis have won significant verdicts in lawsuits against metal hip implant manufacturers over the past decade.

Bloomberg Law reports that Zimmer Biomet has recently announced it will appeal a $21 million verdict in a Missouri lawsuit over its hip implant. A woman who claims she suffered significant injuries brought the lawsuit, resulting in the multimillion dollar jury award for compensatory damages. According to an attorney in the case, this is the largest individual hip implant lawsuit verdict ever.

In 2016, a Dallas jury reportedly awarded a $1 billion verdict to six plaintiffs who claimed that a DePuy metal help implant caused injuries because of its metal-on-metal design. Reuters reported that this verdict joined another $2.5 billion verdict over parent company Johnson & Johnson’s ASR metal hip implants.

Reuters also noted in 2019 that Johnson & Johnson agreed to pay $120 million to settle a lawsuit over its metal-on-metal hip implant. The lawsuit, filed by 46 state attorney generals, alleged its subsidiary, DePuy Orthopedics, falsely advertised its ASR XL and Pinnacle Ultamet hip implants.

Stryker hip implants have also led to mega settlements. Reportedly, the company agreed to pay a total of $1.4 billion to settle over 3,500 metal hip implant cases between 2014 and 2016. The lawsuits reportedly alleged that the Stryker implants released metal ions into patients, resulting in severe side effects.

Join a Free Metal Hip Implant Revision Surgery Lawsuit Investigation

If you or someone you know has or needs to have your metal on metal hip implant replaced because of any of a number of complications, a hip implant attorney would like to speak with you to determine if you are owed compensation for your injuries.

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